Kornimate/medical-research-clean huggingface dataset:
metabolic and physiological stress during skiing.

Conditions: Healthy

Summary: problem description in industrialized countries there is a rapid increase in the number of senior citizens. in austria more than 50% of the population is overweight, with highest prevalence in the age group from 60 to 74 yrs and the who lists physical inactivity as one of the main behavioral risk factors of cardiovascular diseases. especially in winter months, activity related energy expenditure was 40% and 31% lower in the us and canada, respectively. in addition, in an austrian study the winter season was associated with higher blood pressure, total cholesterol and body mass index, giving an increasing risk of chronic coronary disease by 6.8% in men and 3.6% in women. therefore, the development of intervention programs that overcome the winter physical activity deficit and be feasible also for elderly should be goal of future research. alpine skiing (as) and cross country skiing (xcs) have a long standing tradition in austria and could potentially fill the winter physical activity gap. the salzburg skiing for the elderly study (sases) has found as to be a save and feasible possibility to improve the health of the aged population in many parameters. xcs as a competitive sport is already well explored but there are hardly any studies about its effects in the normal or elderly population. unfortunately knowledge about the differences between as and xcs in the physiological adaptation processes in the elderly population is also lacking. aims and hypotheses of the pre-study in order to standardize training interventions, the present pre-study aims at comparing physiological and metabolic parameters between as, xcs and it. therefore, the results of the pre-study serve as determinants for the training parameters of the above mentioned main study. we postulate that, based on the results of the present study, it is possible to set up comparable isocaloric training sessions for as, xcs and it for elderly and unfit persons. furthermore, we assume that elderly and unfit subjects are able to perform a full spectrum of intensities and techniques necessary to set appropriate stimuli for isocaloric comparison. we hypothesize arterial stiffness indices and circulating microrna (mirna) patterns to change due to one bout of physical activity of as, xcs, and it with variations depending on the kind of sport.


Eligibility criteria:
inclusion criteria: * written informed consent * male or female * age: 30+ years * inconspicuous ecg * non-smoker for at least one year * proper skills in alpine skiing and cross-country skiing exclusion criteria: * participation in other clinical trials at the same time or within the previous 6 months * tiffeneau-pinelli index: forced expiratory volume in first second (fev1) / forced vital capacity (fvc) \<60% with/without symptoms (coughing, sputum) or other evidence of a pulmonary disease * medical condition which conflicts with participation in training * intake of anticoagulants * alcohol or drug abuse * severe obesity: bmi \>40

Keywords: alpine skiing cross country skiing indoor cycling physical fitness training status metabolic equivalent
study of the effect of dosing on clozapine levels

Conditions: Psychotic Disorders; Schizophrenia

Summary: the objectives of this 15-day study are: 1. to compare steady-state trough plasma concentrations of clozapine and its metabolite norclozapine when given once daily and twice daily (at the same total daily dose) 2. to determine if frequency of clozapine administration has an effect on: 1. symptoms of schizophrenia 2. adverse effects of clozapine 3. fasting blood glucose, lipids, creatinine, and urea 4. weight and waist circumference

it is important that clinicians do everything possible to optimize the use of clozapine in individuals with treatment-resistant schizophrenia. to our knowledge, there are no published studies evaluating whether twice daily administration of clozapine is better than once daily administration in terms of effectiveness and tolerability. although this may seem trivial at first, when we consider that clozapine has a relatively short half-life and dissociates quickly from the dopamine d2 receptor, it justifies further consideration. it takes on even more significance knowing that the established threshold clozapine plasma concentration for therapeutic response (i.e., 350-420 ng/ml) was determined using steady-state trough plasma samples (i.e., approximately 12 hours after the evening dose) in patients administered clozapine twice rather than once daily.

Eligibility criteria:
inclusion criteria: * participants must be between the ages of 19 - 65 * participants must be fluent in english * participants must have a psychiatric diagnosis and are currently treated with clozapine once daily in the evening * participants must be on a stable dose of clozapine for at least one week to ensure steady-state has been achieved exclusion criteria: * participants who are hypersensitive to clozapine * participants who are pregnant or lactating * participants who are of childbearing age and not using reliable contraception * participants who have postsurgical complications of the gastrointestinal tract that might impair absorption * participants who have any clinically relevant abnormalities of laboratory parameters * participants who have had a potent cyp1a2 metabolic inducer (e.g., carbamazepine; rifampin) or inhibitor (e.g., amiodarone; cimetidine; efavirenz; fluoroquinolone antibiotics; ticlopidine) added to and/or removed from their medication regimen in the past two weeks

Keywords: clozapine psychotropic drugs antipsychotic agents psychotic disorders schizophrenia adverse effects drug monitoring
computerized tomography to help diagnosis pediatrics scaphoid fractures.

Conditions: Scaphoid Bone; Fracture

Summary: the purpose of this study is to find out whether computerized tomography will be better than plain radiographs in determining pediatrics scaphoid fractures.

background: the use of plain radiograph in the detection of pediatrics scaphoid fractures has low specificity and sensitivity. patients with documented anatomical snuffbox tenderness and negative plain radiographs are casted in thumb spica casts and seen by a pediatrics orthopedics surgeon. however few patients with clinical scaphoid fractures have documented scaphoid fractures, with the most common injury of soft tissue injury to the surrounding tissues. the use of ct scan to detect scaphoid fractures is not well documented and may be an appropriate substitute for plain radiographs. hypothesis: ct scan of the wrist will have higher sensitivity and specificity in detecting pediatrics scaphoid fracture than plain radiographs.

Eligibility criteria:
inclusion criteria: * pain in anatomical snuffbox, negative radiographs, less than 18 years old, older than 6 years old, injury less than 1 week old and provision of informed consent exclusion criteria: * previous injury to scaphoid bone, other injuries on the same extremity, vascular injury present at the injury site, fracture seen on initial radiographs, injury \>1 week old, inability for patient to comply with rehabilitation or form completion, likely problems in maintaining patient follow-up

Keywords: clinical scaphoid fracture pediatric
bilateral erector spinae plane block versus local anesthetic infiltration for perioperative analgesia in spine surgery.

Conditions: Pain, Postoperative; SPINAL Fracture; Spondylolisthesis

Summary: postoperative pain still represents an important perioperative issue, affecting more than 80% of patients undergoing surgery. a suboptimal pain management doesn't just affects quality of life, but can compromise rehabilitation plan, increase morbidity and determine the development of chronic pain. last but not least, far from being just an obligation for physicians, a good analgesia is a fundamental right of every patient. in order to meet these important demands, a great number of guidelines has been provided, all of these underlying that the centerpiece of postoperative analgesia lies in the multimodality management, thereby combining different medications and different ways of delivering them, with the aim of targeting distinct receptor systems and improving efficacy, while limiting side effects. in 2018, the investigators conducted a case-series analysis on 17 patients undergoing lumbar surgery to find out the role of sublingual sufentanil tablet system (ssts) in a multimodal analgesia regimen. patients expressed a good pain relief, with most benefit during physiotherapy sessions and early discharges, in absence of side effects. since then, ssts has been part of regular clinical practice in our hospital. the aim of this randomized trial is to examine the analgesic efficacy and the opioid sparing role in spine surgery of a recently developed regional anesthesia technique, the erector spinae plane block (esp block), as opposed to local anaesthetic (la) wound infiltration. the latter is a widespread, simple and unexpensive mean of providing postoperative analgesia. on the other hand, esp block is an ultrasound-guided interfascial plain block, in which la is injected below the erector spine muscle, closer to costotransverse foramina and origin of dorsal and ventral rami. it does provide an efficient multidermatomal sensory blockade (according to craniocaudal la spread), with the advantage of being simple and safe.


Eligibility criteria:
inclusion criteria: * patients scheduled for lumbar fusion surgery on account of vertebral fractures or degenerative spondylolisthesis. * patients consent. exclusion criteria: * opioid tolerance; * documented sleep apnoea or home oxygen therapy; * history of alcohol or drug abuse; * patients with an allergy or hypersensitivity to opioids.

Keywords: analgesia, patient-controlled anesthetics, local pain, postoperative
prognostic pet/ct model in non small cell lung cancer

Conditions: Non Small Cell Lung Cancer

Summary: prospective validation of a prognostic model based on advanced pet/ct image analysis in non small cell lung cancer

validation on a prospective cohort of patient of a predictive model for survival based on image derived parameters

Eligibility criteria:
inclusion criteria: * non small cell lung cancer * initial fluorodeoxygluoces (fdg) pet/ct before treatment exclusion criteria: * none

Keywords: pet/ct image processing outcome
translating extinction research to improve pharmacotherapy for tobacco dependence

Conditions: Smoking Cessation; Tobacco Dependence

Summary: the purpose of this pilot feasibility study is to find out the effect of different behavioral treatments along with different duration of a drug called varenicline, on smoking behavior and quitting smoking. varenicline, also known as chantix™, is an fda-approved medication that has been shown to help people quit smoking.

following the initial telephone screening, eligible participants will be scheduled for a screening evaluation session. following the screening evaluation, participants who pass the medical screening and meet all other inclusion criteria will be scheduled for their first assessment and then randomized to receive standard varenicline (sv), extended varenicline (ev), or extended varenicline plus facilitated extinction (ev + fe). the randomization list will be generated by the study statistician. it will be stratified by gender and will employ a variable block randomization that will guarantee that the arms are balanced when a given block is filled.

Eligibility criteria:
inclusion criteria: * ≥18 years of age * smoke at least 10 cigarettes daily for the past year * expired-air carbon monoxide (co) \> 8 ppm * medically eligible to receive varenicline * score at least a 5 on the contemplation ladder (biener \& abrams 1991), a measure of motivation to quit smoking. exclusion criteria: * are pregnant or lactating * have renal dysfunction * have a history of seizures * are medically at risk in the judgment of the study physician * have ever used varenicline * have used other smoking cessation medications within the past three months * have current psychiatric disorders (i.e. major depression, bipolar, and/or psychotic disorders) * have substance use disorder as determined by a psychiatric screener (mini international neuropsychiatric interview \[mini\]; sheehan et al 2015). * we must limit the number of participants from the same street address to 1.

Keywords: pharmacotherapy
impact of non-invasive brain stimulation on motor recuperation

Conditions: Stroke

Summary: tdcs (transcranial direct current stimulation) will be used in chronic stroke patients to improve a variety of functions with superior or inferior limb.

tdcs will be used in chronic stroke patients to improve a variety of functions such as motor functions with superior or inferior limb. tdcs will be applied in a placebo-controlled, double-blind, randomised fashion. behavioural data will be collected before and after tdcs, as well as brain functional imaging data.

Eligibility criteria:
inclusion criteria: * stroke with at least slight deficit in superior or inferior limb exclusion criteria: * epilepsy * contraindication to tdcs and/or to fmri * presence of metal in the head * inability to understand/complete behavioural tasks * chronic intake of alcohol or recreative drugs * major health condition * presence of pacemaker * pregnancy

Keywords: stroke
accuracy of contrast-enhanced ultrasound for hepatocellular carcinoma post tace

Conditions: Hepatocellular Carcinoma

Summary: the purpose of this research study is to find out if a different type of imaging study called contrast enhanced ultrasound (ceus) is as good as, or better than ct or mri in patients diagnosed with hepatocellular carcinoma (hcc) after receiving tace treatment

this is a prospective trial to determine if contrast enhanced ultrasound (ceus) is non-inferior to ct or mri in patients with hepatocellular carcinoma (hcc) following transcatheter arterial chemoembolization(tace) treatments. all patients will receive standard of care ct/mri and will also get a contrast ultrasound to directly compare. timepoint 0- our proposed study population includes subjects with diagnosed hcc, who are treated with tace. patients will be identified and enrolled at the time of initial tace. timepoint 1- following initial tace, patients will receive a ct or mri, as routinely ordered in the post-tace setting, to assess for residual or new hcc. at this same imaging follow-up visit, patients will also receive a one-time additional contrast-enhanced ultrasound (ceus). timepoint 2- per standard clinical care, patients typically return for repeat imaging (ct/mri) within 2-4 months following the first imaging visit.

Eligibility criteria:
inclusion criteria: * adult (≥18 years of age) patients with diagnosed hcc (via imaging, biopsy, or combination of imaging and biochemical markers), who are treated with their first round of tace. * sex: male or female * bmi ≤ 40 exclusion criteria: * children (\<18), pregnant patients * patients who do not speak english * patients with a history of hypersensitivity reactions to sulfur hexafluoride lipid microsphere components or to any of the inactive ingredients in lumason. * patients with unstable cardiopulmonary conditions (acute myocardial infarction, acute coronary artery syndromes, worsening or unstable congestive heart failure, or serious ventricular arrhythmias) * patients who have a prior non-contrast ultrasound, within last 3 months (at time of consent), where the tumor could not be seen - most commonly due to severe steatosis or obesity. * pregnant or nursing woman * patients who do not plan to get their follow-up ct/mri at hershey medical center.
yield rate for procurement the histologic core with endoscopic ultrasound-guided fine needle biopsy with 20-gauge ultrasound biopsy needles for solid pancreatic masses: pilot study

Conditions: Pancreatic Cancer; Solid Pancreatic and Peripancreatic Lesion

Summary: to investigate the technical feasibility and diagnostic yield of new 20-gauge procore needle for eus-guided fine needle biopsy in pancreatic solid lesions.

pancreatic ductal adenocarcinoma is the fourth cause of death in the western world. surgery remains the only treatment offering an advantage in terms of overall survival (5-year survival range, 15-25%), but unfortunately only 10-20% of patients present resectable disease at the time of diagnosis. regarding the diagnosis of pancreatic cancer, proper tool with high diagnostic yield is very important. the investigators investigated the technical feasibility and diagnostic yield of recent-developed new 20-gauge procore needle for eus-guided fine needle biopsy in pancreatic solid lesions. the investigators applied the 20-gauge procore needle for eus-guided fine needle biopsy in the diagnosis of pancreatic solid mass. a total of 30 patients will be enrolled for the present pilot study.

Eligibility criteria:
inclusion criteria: * patients who are at least 20 years of age * patients who require endoscopic ultrasound-guided fine needle aspiration cytology or biopsy because of pancreatic or peripancreatic solid mass. exclusion criteria: * cystic pancreatic mass in imaging tests such as ct or mri or us * haemodynamically unstable patients * severe coagulopathy (international normalized ratio \[inr\] \> 1.5 or platelet count \< 50,000 cells/cubic millimeter \[cmm3\]) * patients unable to quit anticoagulant/anti-platelet therapy * pregnancy
the epidemiology and approach to differentiating etiologies of shock in the emergency department

Conditions: Undifferentiated Shock

Summary: the shock tool study is designed to improve the clinical evaluation for differentiating shock in the emergency department. the goal of this study is to evaluate and improve the accuracy of physicians differentiating causes of shock.

specific aim #1: to study the epidemiology of shock in the emergency department hypothesis 1: we will better understand shock states if we determine shock etiology among patients presenting to the emergency department in a carefully conducted observational prospective study. specific aim #2: to determine the accuracy of physician diagnosis for the underlying etiology of shock. hypothesis 2: physician assessment of the underlying cause of shock is challenging and often inaccurate in the early stages of care in the emergency department. specific aim #3: to optimize the evidence-based approach to assist in the diagnosis of shock etiology from elements readily available when a patient demonstrates shock physiology in the emergency department. hypothesis 3: an evidenced-based, standardized approach to clinical decision making integrating elements of the history, physical exam, and early testing will improve a physician's ability to accurately differentiate etiologies of shock.

Eligibility criteria:
inclusion criteria: * age 18 years or great * for pre-shock cohort: hr \> 130, rr\>24, shock index \> 1, lactate \> 4.0mmol/l, sbp \< 90mm/hg) * for shock cohort: persistent blood pressure \<90mm/hg after resuscitation exclusion criteria: * seizure * isolated atrial fibrillation with discharge after rate control achieved * discharged from the emergency department * intoxication or withdrawal

Keywords: shock predicting diagnosis predicting adverse outcomes
effects of a dietary fibre supplementation of a low calorie diet on appetite and body weight

Conditions: Appetite Suppression; Weight Loss

Summary: this 18 week, randomized, double blind, placebo controlled trial will examine the effects of thick dietary fibre (pgx) supplementation of a low calorie diet (lcd) on appetite, weight loss, body composition, and compliance in overweight and moderately obese female. the investigators believe that 15 grams/day pgx supplementation of a low calorie diet over a 14-weeks period will elicit a better appetite score (e.g. reduced hunger) compared to the rice flour supplementation of the lcd.


Eligibility criteria:
inclusion criteria: * bmi 25 - 35 kg/m2 exclusion criteria: * medications and supplements that affect appetite * known diabetes * contraindications to lcd * any other medical, social or geographic condition, which, in the opinion of the investigator would not allow safe completion of the protocol.

Keywords: viscous fibre polysaccharide appetite hunger satiety weight management
renal biopsies in post-liver transplantation patients with renal impairment

Conditions: Liver Transplantation; Renal Insufficiency, Chronic

Summary: investigators will conduct this single-center, prospective cohort study to explore the prevalence and risk factors of renal function progression in post-liver transplantation patients with renal impairment after renal biospy and to understand the the pathology of kidney disease in post-liver transplantation patients with renal impairment.

this is a single-center, prospective, cohort study. this study will include approximate 369 post-liver transplantation patients with renal impairment and have received renal biopsy. demographic characteristics, medical history, etiology of liver failure, concomitant medications, baseline laboratory parameters, etc., will be recorded. all participants will receive standard treatment by hepatologists and nephrologists based on the pathological results. all participants will be followed up for 96 weeks. renal function, concomitant medications, and other laboratory parameters, etc., will be obtained.

Eligibility criteria:
inclusion criteria: * age 18-75 years * patients received liver transplantation * new onset of proteinuria(defined as 24-hour proteinuria\>1g/24h, or urinary albumin creatinine ratio(uacr)\>300mg/g at least two occasions * have received renal biopsy in the past 3 months * signed informed consent form(icf) exclusion criteria: * patients received renal transplantation * hepatic failure * severe bleeding risk or platelet \<70\*109/l * chronic kidney insufficiency with egfr\<30ml/min·1.73m2,or kidney atrophy, or solitary kidney, or medullary sponge kidney, or polycystic kidney, or obstructive nephropathy * uncontrolled mental disease or unable to cooperate during operation * pregnancy or lactation * not suitable for this study judged by investigaters

Keywords: liver transplantation renal biopsy chronic kidney disease
phase 2 study of tmx-049 in subjects with type 2 diabetes and albuminuria

Conditions: Diabetic Kidney Disease

Summary: the primary objective of this study is to assess the effect of 2 dose levels of tmx-049 on urinary albumin excretion in subjects with type 2 diabetes and albuminuria (a urinary albumin-to-creatinine ratio (uacr) 200 to 3000 mg/g and an estimated glomerular filtration rate (egfr) ≥30 ml/min/1.73m2). effects of each tmx-049 dose on uacr will be assessed in terms of ratios using log-transformed uacr at baseline and after a 12-week period of treatment.


Eligibility criteria:
inclusion criteria: * type 2 diabetes treated with ≥1 glucose-lowering medication for at least 12 months * uacr 200 to 3000 mg/g * egfr ≥30 ml/min/1.73m2 * treated with at least the minimal recommended dose of an angiotensin converting enzyme inhibitor (acei) or an angiotensin ii receptor blocker (arb), but not both exclusion criteria: * history of type 1 diabetes * women who are breast feeding * treatment with any uric acid-lowering therapy within previous 2 weeks * history of intolerance to any xo (xanthine oxidase) inhibitor * history of a gout flare requiring pharmacologic treatment * history or presence of tophaceous gout * history of immunosuppressant treatment for any known or suspected renal disorder * history of a non-diabetic form of renal disease * glycosylated hemoglobin (hba1c) \>11% * sua \ 10.0 mg/dl * positive urinary pregnancy test * dialysis for acute renal failure within previous 6 months * renal allograft in place or a scheduled kidney transplant within the next 22 weeks * congenital or acquired solitary kidney

Keywords: diabetic kidney disease xo inhibitor uacr